Mind Map Of CPR

Shockable and non-shockable cardiac arrest pathNon vagus-induced bradycardiaShock resistant ventricular fibrillation or pulseless ventricular tachycardiacardiopulmonary resuscitation (CPR)1.Definition2.Assess for signs of life or response7.Technique8.Post resuscitation care - following return of spontaneous circulationExternal cardiac compressionRatio for CPR is 2 breaths : 15 compressionsCPR rate for all ages 100–120 bpmOnce patient intubated compressions and breaths are independent of each other: compressions continue at rate 100–120 bpm and breaths at rate of 10 bpmFor newborn infants the best technique is a two-handed hold in which both thumbs compress the sternumContinue CPRUse the hand technique that allows you to achieve this:Oxygen awayCompress sternum 1/3 the depth of the chestPerform external cardiac compressions to the lower half of the sternum in all patients including newbornsDetermine the cardiac rhythm: shockable or non-shockableA – AirwayB – BreathingC - CirculationIf no pulse, slow pulse (<60 in an infant) or unsure, continue CPR3.AttentionIf signs of life assess pulseEnsure adequacy of ventilationCPR stands for CardioPulmonary Resuscitation, an emergency procedure that is a combination of chest compressions and artificial ventilation (breathing) used to save a person’s life when a person’s heart stops beating or breathing ceases. When performed right away, CPR can increase a person’s chances of survival after cardiac arrest.Intubation should be considered for persistent obstructed airway or at some stage during CPRMonitor for return of spontaneous circulation4.MedicationsAmiodarone"HANDS OFF” – pad placement or DC shock – “Continue CPR" – “HANDS ON”Adrenaline DoseAssessment of pulse can be difficult and inaccurateDO NOT interrupt CPR except for rhythm check or defibrillationPalpate central pulse (brachial, femoral, carotid)Place the child on a firm surface. If on a bed, place the cardiac compression board under the patient, not under the mattress5.During resuscitationCorrect treatable causesIf no signs of life continue CPRIntubation should be considered for persistent obstructed airway or at some stage during CPR6.Defibrillator operator instructionsLook, listen, feel for patency/added noisesOptimise head positionConsider simple airway manoeuvres (head-tilt chin-lift or jaw thrust)Suction secretions/blood/vomitLook for chest rise and fall and auscultateCommence artificial ventilation with self-inflating bag-valve-mask or anaesthetic t-piece using 100% oxygenConsider oro/nasopharyngeal airway for upper airway obstructionConsider 2-person technique for poor mask sealAll clearChargeHands offEvaluate rhythmDefibrillate or ‘dump charge’Continue CPR until the next designated rhythm checkGain IV access as soon as possibleIf DC shock delivered, recommence CPR immediately for 2 minutes prior to rhythm checkHypoxaemiaHypovolaemiaHypo/hyperthermiaHypo/hyperkalaemiaTamponadeTension pneumothoraxToxins/poisons/drugsThrombosis Dose5 mg/kg IV/IO10 microgram/kg =0.1 mL/kg IV/IM/IOAtropine, lidocaine, sodium bicarbonate and calcium are only considered in specific situationsRe-evaluate ABCDEnsure airway and breathing are managed effectively, including intubation if not already performed; do not extubateTitrate inspired to achieve normal saturations, avoid excessive oxygenationVentilate to normal CO2Perform CXR to confirm ETT in desired position and check for complications of CPR (pneumothorax, rib fractures, aspiration)Maintain normal blood pressure appropriate for age with use of inotropes as neededPerform 12 lead ECGMonitor for further arrhythmias and consider ongoing anti-arrhythmic medicationConsider echocardiography to monitor contractility and exclude tamponadeCheck haemoglobin, pH, electrolytes and glucose and correct as necessaryAim for normal temperature (avoid hypo/hyperthermia)Use adequate sedation and analgesiaFor rhythm check consider “COACHED”Students workHadi alsharyahMohammed alzaedyMashael alrashdiShua’a alenaziAhlam almurashi
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